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General NPI Number Information
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NPI Number | 1174816136
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Entity Type | Individual
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Provider Name | LISA K NAKAMURA LMT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 1580 MAKALOA ST STE 880
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City | HONOLULU
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State | HI
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Zip | 96814-3258
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Country | US
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Telephone | 808-728-3013
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Fax | 808-836-1490
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Provider Business Mailing Address
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Address Line | 3028 KANU ST
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City | HONOLULU
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State | HI
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Zip | 96822-1522
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Country | US
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Telephone | 808-728-3013
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Fax | 808-836-1490
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MAT11361
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License Number State | HI
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